Cytoreductive Nephrectomy Offers a Survival Edge in mRCC – Renal and Urology News

Cytoreductive nephrectomy (CN) improves survival in patients with metastatic renal cell carcinoma (mRCC) receiving modern immunotherapy, according to study findings presented at the 20th annual meeting of the Society of Urologic Oncology in Washington, DC.

NirmishSingla, MD, MSCS, of the University of Texas Southwestern Medical Center inDallas, and colleagues studied 391 patients diagnosed with mRCC between 2015and 2016 who were identified using the National Cancer Data Base (NCDB). Ofthese, 221 (56.5%) received both CN and immunotherapy and 170 (43.5%) receivedimmunotherapy only. Of the 221 patients who received both treatments, 197 hadupfront CN prior to immunotherapy and 24 received immunotherapy prior to CN.The median follow-up was 14.7 months among 183 patients with available survivaldata.

Patientswho underwent CN plus immunotherapy had a significant 77% decreased risk ofdeath compared with the immunotherapy-only group. Immunotherapy given prior toCN resulted in lower pT stage, Fuhrman grade, tumor size, and frequency oflymphovascular invasion compared with upfront CN, Dr Singlas team reported.

Theinvestigators observed no positive surgical margins, 30-day readmissions, orprolonged inpatient length-of-stay among patients undergoing delayed CN afterimmunotherapy.

Thisretrospective analysis must be interpreted within the context of limitationsand biases inherent to the NCDB, Dr Singla told Renal & Urology News. However, our findings support anoncologic role for CN in the modern IO [immunotherapy] era and providepreliminary evidence regarding the timing and safety of CN relative to IOadministration. Prospective validation is indeed warranted.


SinglaN, Hutchinson R, Ghandour R, et al. Improved survival after cytoreductivenephrectomy for metastatic renal cell carcinoma in the contemporaryimmunotherapy era: A national population-based analysis. Presented at theSociety of Urologic Oncology 20th annual meeting held December 4 to 6 inWashington, DC. Poster 43.

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Cytoreductive Nephrectomy Offers a Survival Edge in mRCC - Renal and Urology News

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